Provider Demographics
NPI:1922428762
Name:NAFTAL, BOB (MS, BSL)
Entity Type:Individual
Prefix:
First Name:BOB
Middle Name:
Last Name:NAFTAL
Suffix:
Gender:M
Credentials:MS, BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:SPRING CITY
Mailing Address - State:PA
Mailing Address - Zip Code:19475-2112
Mailing Address - Country:US
Mailing Address - Phone:610-401-8713
Mailing Address - Fax:
Practice Address - Street 1:203 WALNUT ST
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:PA
Practice Address - Zip Code:19475-2112
Practice Address - Country:US
Practice Address - Phone:610-401-8713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-20
Last Update Date:2014-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000395103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst